Strategies to improve DEI in obstetrics and gynecology

Metrics, wellness models, and management change are essential to advancing diversity, equity, and inclusion (DEI) in obstetrics and gynecology, according to a presentation at the 2022 American College of Obstetricians & Gynecologists' Annual Clinical & Scientific Meeting held in San Diego, California from May 6-8.¹

Andrea Braden, MD, assistant professor at Emory University School of Medicine, and co-founder and CEO of Lybbie; Catherine Cansino, MD, associate clinical professor at the University of California, Davis; and Lisa Foglia, MD, DIO/DME at the Womack Army Medical Center discusses a variety of strategies to help improve DEI in the presentation, “Advancing diversity and equity in obstetrics and Gynecology.”

Cansino specifically outlined the importance of utilizing metrics to promote a more equitable environment, while Foglia discussed the need for change of management in respect to culture change and Braden introduced innovative wellness models to make women’s wellness in medicine sustainable, as well as promote advancement and retention of women in medicine.

While obstetrics and gynecology is made up of a larger percentage of women compared to other specialties, according to Cansino, representation stills severely lacks among leadership positions as well as for people of color within the specialty.

“When you look at academic institutions, whether it’s division leaders, department chairs, dean positions, etc, there isn’t very much representation whether you’re looking at gender diversity, race, or other identities,” said Cansino.

Specifically, Foglia added, only 28% of women are department chairs, 38% are full professors, and 60% are in residency training, further emphasizing her point that leadership within obstetrics and gynecology does not proportionately match the specialties training population or the patients that they serve.

“It seems like it’s a vicious cycle of increased demands on women, which leads to increased rates of burnout for female positions in obstetrics and gynecology, and this just decreases rates of retention and promotion which perpetuates the gender-leadership disparities,” echoed Braden.

All speakers agreed that it will take restructuring at the leadership level to effectively implement change and demonstrate.

When asked about the importance of representation within obstetrics and gynecology, Braden told Contemporary OB/GYN® that year after year more women are requesting female providers within this specialty as they understand the experience at a personal level.

“When we have more equitable representation of providers across the board in any specialty, you’re able to understand the experiences of our patient base and provide more equitable care across the board,” said Braden.

Cansino also emphasized the importance of utilizing metrics to promote a more equitable environment. However, she added, more data is not needed. Instead, metrics are needed to anchor interventions, such as treatments, programs, or advocacy, to data and to know how successful those interventions are.

Ultimately, Foglia provided some useful strategies that can be implemented to promote better representation in obstetrics and gynecology, one of which includes having representation on interview panels and inviting those individuals to submit questions.

“I think that gives you insight into what’s important to the people who work in your organization, and it also invites people into the room who have different viewpoints and opinions from you,” said Foglia. “This is so you can avoid selecting people who look and sound just like you just because of affinity bias.”

Reference

1. Cansino C, Foglia L, Braden A. Advancing Diversity and Equity in Obstetrics and Gynecology. Presented at: 2022 American College of Obstetrics and Gynecology Annual Clinical & Scientific Meeting; May 6 to May 8, 2022.